Listening to Small Business on Health Reform

One evening last week the NC Justice Center’s Health Access Coalition hosted a dinner for small business people in Durham to consider issues around health reform. This is the start of an ongoing series of small business roundtables we will be holding around North Carolina to listen to what small business folks think about reform, what problems they are experiencing, and what solutions they think would work for them.

Small business owners and workers are where the health insurance crisis makes itself felt. According to the NC Institute of Medicine, 36% of people uninsured in NC have a family connection to an employer with less than 25 employees. Less than 50% of workers at firms with less than 10 employees are even offered insurance. Why? It’s just too expensive for a small business. Talking to small business people about health reform is illuminating:

They have a variety of views. One restaurant owner felt a government-run health plan would be a huge mistake. Another business owner was so sick of dealing with insurers that he was enthusiastic about a single-payer health plan. Everyone agreed however that the need for change was critical.

They are sick of rising costs. One owner recounted how he had moved his employees to high-deductible health savings account plans to save money – only to see premium costs rise back up to the same level three years later.

They care about their employees. From worrying that administering a health plan for employees means they have to know too much about their worker’s personal lives to feeling enormous frustration about not being able to “do the right thing” and offer affordable coverage, concern for employees came through loud and clear.

They want a simple and affordable quality health option. Many would prefer not to deal with health coverage at all and have health care go with the individual rather than the business. Failing that, they want simple plans with simple pricing that an ordinary person can understand – and that actually provide real coverage.

I’m excited to do more of these roundtables around North Carolina. Small businesses are on the front lines of our health insurance crisis, and their support will be crucial for any real health reform. Listening to what they have to say is critical.